Implant alignment system

Abstract

A joint prosthesis and/or trial implant alignment system (10) for intraoperatively assisting an alignment of a joint prosthesis and/or trial implant (12) during a surgical procedure is disclosed. The system comprises patient-specific pre-operative data (14) forming a three-dimensional image (14) containing bone structure (32) and a predetermined alignment of the joint prosthesis and/or trial implant (12) thereon. A patient imaging device (16) is for producing patient-specific intraoperative data 18 which forms a two-dimensional image 18 showing bone structure (32) and a real-time position of the joint prosthesis and/or trial implant (12) thereon. Registration means (20) registers the intraoperative data 18 with the pre-operative data (14) based on geometry of said bone structure and/or geometry of said joint prosthesis and/or trial implant (12). A display device (22) for displaying an output of the registration means (20), thereby enabling a visual indication of the said real-time alignment of the joint prosthesis and/or trial implant (12) relative to the said predetermined alignment.

The invention claimed is: 
     
       1. A joint prosthesis and/or trial implant alignment system ( 10 ) for intraoperatively assisting an alignment of a joint prosthesis and/or trial implant ( 12 ) during a surgical procedure, the system ( 10 ) comprising:
 a patient imaging device ( 16 ) for intraoperatively imaging in two dimensions an operative area of the patient; 
 registration circuitry ( 20 ) configured to register patient-specific intraoperative data ( 18 ) received from the patient imaging device ( 16 ) forming a two-dimensional image showing bone structure ( 32 ) and a real-time position of a joint prosthesis and/or trial implant ( 12 ) thereon with patient-specific pre-operative data ( 14 ) forming a three-dimensional image containing bone structure ( 32 ) and a predetermined alignment of the joint prosthesis and/or trial implant ( 12 ) thereon based on geometry of said bone structure ( 32 ) and/or geometry of said joint prosthesis and/or trial implant ( 12 ), and enable a visual indication of real-time alignment of the joint prosthesis and/or trial implant ( 12 ) relative to said predetermined alignment; and 
 a display device ( 22 ) configured to intraoperatively display an output of the registration circuitry's visual indication of real-time alignment of the joint prosthesis and/or trial implant ( 12 ) relative to said predetermined alignment. 
 
     
     
       2. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein the geometry of said bone structure and/or geometry of said joint prosthesis and/or trial implant ( 12 ) includes at least one of a point, contour, profile, plane, line, curvature or radius. 
     
     
       3. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 2 , wherein the registration circuitry ( 20 ) includes contouring determination circuitry for determining contouring of at least one of bone structure, the joint prosthesis and trial implant ( 12 ) in the patient-specific intraoperative data ( 18 ) and/or patient-specific pre-operative data ( 14 ). 
     
     
       4. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 3 , wherein the contouring determination circuitry is configured to determine contouring of at least one of the bone structure, the joint prosthesis and trial implant ( 12 ) in the two-dimensional image and/or three-dimensional image. 
     
     
       5. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein the registration circuitry ( 20 ) includes contouring determination circuitry for determining contouring of at least one of bone structure, the joint prosthesis and trial implant ( 12 ) in the patient-specific intraoperative data ( 18 ) and/or patient-specific pre-operative data ( 14 ). 
     
     
       6. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 5 , wherein the contouring determination circuitry is configured to determine contouring of at least one of the bone structure, the joint prosthesis and trial implant ( 12 ) in the two-dimensional image and/or three-dimensional image. 
     
     
       7. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein the registration circuitry ( 20 ) includes landmark designation circuitry for designating a landmark of at least one of the bone structure ( 32 ), joint prosthesis, and trial implant ( 12 ) that is common to both the patient-specific intraoperative data ( 18 ) and patient-specific pre-operative data ( 14 ). 
     
     
       8. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 7 , wherein the landmark designation circuitry is configured to designate at least one of the landmark of bone structure ( 32 ), joint prosthesis and trial implant ( 12 ) that is common to the two-dimensional image and three-dimensional image or a further landmark of bone structure ( 32 ), joint prosthesis and trial implant ( 12 ) that is common to the two-dimensional image and three-dimensional image. 
     
     
       9. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein said output of the registration circuitry ( 20 ) includes the two-dimensional image superimposed on the three-dimensional image or the three-dimensional image superimposed on the two-dimensional image. 
     
     
       10. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein said output of the registration circuitry ( 20 ) includes real-time orientation and/or positioning numerical data of the joint prosthesis and/or trial implant ( 12 ) relative to the bone structure ( 32 ) and/or the predetermined alignment. 
     
     
       11. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein said output of the registration circuitry ( 20 ) includes at least one indicator to indicate a direction and/or magnitude of adjustment to the joint prosthesis and/or trial implant ( 12 ) to correspond with said predetermined alignment. 
     
     
       12. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein said output of the registration circuitry ( 20 ) includes a real-time or pseudo-real-time three-dimensional image produced from a combination of at least part of the patient-specific intraoperative data ( 18 ) and/or patient-specific pre-operative data ( 14 ). 
     
     
       13. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein the patient imaging device ( 16 ) includes at least one of a fluoroscope, X-ray machine, ultrasound, PACS or Therapy Imaging and Model Management System. 
     
     
       14. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , further comprising a wired or wireless data connection ( 50 ) between the patient imaging device ( 16 ) and the registration circuitry ( 20 ) for transferring the patient-specific intraoperative data ( 18 ) to the registration circuitry ( 20 ). 
     
     
       15. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , further comprising a secondary imaging device for producing an intermediate copy of said two-dimensional image for transferal to the registration circuitry ( 20 ). 
     
     
       16. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein the patient-specific pre-operative data ( 14 ) is at least in part received from at least one of single-plane X-ray, multi-plane X-ray, magnetic resonance imaging, computer tomography, ultrasound or statistical shape modelling. 
     
     
       17. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein the predetermined alignment of the joint prosthesis and/or trial implant ( 12 ) is based on patient-specific information which is indicative of one or more dynamic characteristics and post-implant activities preference data. 
     
     
       18. A joint prosthesis and/or trial implant alignment system ( 10 ) as claimed in  claim 1 , wherein the joint prosthesis and/or trial implant ( 12 ) includes an acetabular cup ( 26 ), acetabular cup liner, femoral head ( 28 ), femoral stem ( 30 ), screw, bolts; femoral, tibial and patellar components of a total knee replacement prosthesis; humeral head, glenoid component and/or custom prosthesis and/or trial implant. 
     
     
       19. A joint prosthesis and/or trial implant alignment system for intraoperatively assisting an alignment of a joint prosthesis and/or trial implant during a surgical procedure, the system comprising:
 a patient imaging device for intraoperatively imaging in two dimensions an operative area of the patient; 
 registration circuitry configured to
 register patient-specific intraoperative data received from the patient imaging device forming a two-dimensional image showing bone structure and a real-time position of a joint prosthesis and/or trial implant thereon with patient-specific pre-operative data forming a three-dimensional image containing bone structure and a predetermined alignment of the joint prosthesis and/or trial implant thereon based on geometry of said bone structure and/or geometry of said joint prosthesis and/or trial implant, wherein said geometry includes at least one of a point, contour, profile, plane, line, curvature or radius, and wherein the predetermined alignment of the joint prosthesis and trial implant is based on patient-specific information which is indicative of one or more dynamic characteristics and post-implant activities preference data, 
 determine contouring of bone structure, the joint prosthesis and trial implant in the patient-specific intraoperative data, patient-specific pre-operative data, and the joint prosthesis and trial implant in the two-dimensional image and/or three-dimensional image, 
 designate a landmark of the bone structure, the joint prosthesis, the trial implant that is common to both the patient-specific intraoperative data and the patient-specific pre-operative data, and the joint prosthesis and trial implant that is common to the two-dimensional image and the three-dimensional image, 
 indicate a direction and magnitude of adjustment to the joint prosthesis and trial implant to correspond with the predetermined alignment, 
 output the two-dimensional image superimposed on the three-dimensional image or the three-dimensional image superimposed on the two-dimensional image, 
 output real-time orientation and positioning numerical data of the joint prosthesis and trial implant relative to the bone structure and the predetermined alignment, and 
 output a real-time or pseudo-real-time three-dimensional image produced from a combination of patient-specific intraoperative data and patient-specific pre-operative data; 
 
 a wired or wireless data connection between the patient imaging device and the registration circuitry for transferring the patient-specific intraoperative data to the registration circuitry; 
 a secondary imaging device for producing an intermediate copy of said two-dimensional image for transferal to the registration circuitry; and 
 a display device configured to intraoperatively display an output of the registration circuitry, thereby enabling a visual indication of real-time alignment of the joint prosthesis and/or trial implant relative to the predetermined alignment.